COVID-19 Update: We are committed to providing eye care in a safe environment for our patients and staff during these challenging times.

View our safety procedures video

You can request records from Mid Atlantic Retina by clicking the button below.


Cost

You will receive an estimated cost for records at the time of the request. Once the request is fulfilled, your credit card will be charged for the estimated cost plus the state authorized copying fees.

Payment

Pre-payment for records is required unless otherwise required by state/federal statutes.

Processing Time

Please allow up to 30 days to process your request.

Authorization Signature for Your Records Release

By law, the following authorized people are able to sign for the release of your health information:
  • Yourself (not your spouse)
  • A parent (for patients younger than 18 years of age)
  • Legal guardian (guardianship documentation is required)
  • Power of attorney if patient is unable to sign (legal documentation is required)
  • Estate representative for a deceased patient (estate documentation is required)

Check the Status of your Request

Please click here and enter your Request Number.